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KMID : 0359620090210030197
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Journal of Korean Knee Society
2009 Volume.21 No. 3 p.197 ~ p.204
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Short-term Follow-up Results of Medial Epicondylar Osteotomy for the Varus Knee in TKA
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Sim Jae-Ang
Kwak Ji-Hoon
Yang Sang-Hoon
Kim Joon-Yub
Lee Beom-Koo
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Abstract
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Purpose: We wanted to evaluate the results of medial epicondylar osteotomy for the varus knee when performing total knee arthroplasty.
Materials and Methods: We reviewed 32 cases of medial epicondylar osteotomy for treating varus deformity, and these cases underwent operation from December 2004 to December 2007. The average age of the patients was 71.0-years-old and the average follow-up period was 23.5 months. The clinical outcomes were measured, including the Knee Society score (KSS), the function score (FS) and the range of the motion (ROM). The radiological outcomes were measured by anteroposterior simple radiographs for assessing the union state of the osteotomy site, and the valgus stress radiographs and the whole extremity radiographs were used for assessing the femorotibial angle, the mechanical axis angle and the alignment.
Results: The KSS improved from 46.5±7.6 to 89.1±5.9 points (p＜0.001) and the FS increased from 39.5±9.2 to 84.2±8.5 points (p＜0.001). The range of motion increased from 101.5±28.2° to 116.0±10.8° (p=0.006). Bony union occurred in 22 knees and fibrous union occurred in 10 knees. The femorotibial angle was corrected from varus 8.2±5.0° to valgus 5.6±1.5° (p＜0.001) and the mechanical axis angle was revised from varus 13.9±4.5° to varus 0.7±1.6° (p＜0.001). There were 27 neutral, 4 varus and 1 valgus alignment. On the valgus stress radiographs, the difference compared with the opposite side was 1.0±0.6° and there was no significant difference between the bony union group and the fibrous union group (p=0.175).
Conclusion: Medial epicondylar osteotomy for the varus knee when performing total knee arthroplasty could be a useful ligament balancing technique for achieving medial stability of the knee.
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KEYWORD
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Varus knee, Total knee arthroplasty, Medial epicondylar osteotomy
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